MDS Alert
MDS & Billing News
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Get ready for updated code files for SNF consolidated billing. The annual updated list of HCPCS codes excluded from SNF consolidated billing will be posted at www.cms.hhs.gov/snfconsolidatedbilling. The updated code list goes into effect on Jan. 1, 2007. Got questions about the advance beneficiary notice under development? You can review a pdf of the SNF ABN town hall meeting held in September and a follow-up Q&A document with the most frequently asked questions at the meeting. To access the files, go to
Say goodbye to the Part B rehab therapy cap exceptions as of Jan. 1 unless Congress intervenes ... again. A cap of $1,780 for occupational therapy and $1,780 for physical therapy and speech language and pathology services combined will be in place Jan. 1, 2007 for all settings except the outpatient hospital. Not only that, but the therapy caps exceptions process will no longer be in place as of that date.
If Congress passes legislation providing exceptions, CMS will act as soon as possible, although the agency won't know if the exceptions would be retroactive until officials see what Congress passes, said Ellen Gay, health information specialist for CMS, during the Nov. 29, 2006 SNF LTC/SNF Open Door Forum.
www.cms.hhs.gov/BN/04_FFSSNFABNandSNFDenialLetters.asp#TopOfPage.
The MDS and care planning are once again in the OIG work plan's cross-hair. The 2007 plan says the OIG will examine "the type, frequency, and severity of nursing home deficiencies" related to MDS assessments and care planning. The agency notes that "in previous studies, [it] identified increases in deficiencies related to comprehensive assessments, care planning" and providing services "in accordance with the care plan."
The OIG also plans to look at how nursing homes have implemented Part D -- and whether dual eligible residents are receiving the drugs they need. And the agency will determine whether SNF submit "no pay" bills as required. You can read the entire work plan at http://oig.hhs.gov/publications/workplan.html.
MDS Alert
- MEDICAL NECESSITY:
Breathe Easy When You Skill A Resident For Oxygen Therapy
O2 is no automatic shoe-in for a Part A stay. Coding oxygen at P1ag will [...] - MDS ACCURACY:
Don't Let Your Facility Eat The Costs Of ADL Care
4 strategies keep eating scores from dinging the RUGs. To boost paltry RUG scores, home [...] - PAYMENT:
Boost Residents' ADL Scores By Capturing IV Fluids At K5a
Stay in the cash flow with this inside advice. Failing to code an IV can [...] - CODING QUIZZER:
Code These Scenarios For Section G1h (Eating)
Ready, set ... get ready to code 1, 2 or 3. Code the following examples [...] - CLIP & SAVE:
Know The Score For G1h (Eating)
Here's how the RUG grouper calculates the points. The RUG grouper only uses the self-performance [...] - DIAGNOSIS CODING:
Before You Code Section I: Perform These 2 Double Checks
These steps taken in time can head off care, compliance woes. Incorrectly identifying and coding [...] - QUALITY MEASURES:
Beware--A Dash Won't Give You A Shot At Improving Your Flu Vaccination QM
Yes, you can code a dash but ... here's the rest of the story. Putting [...] - CLIP & SAVE:
Don't Get Stuck With A Poor Showing On The New Flu Vaccination QMs
Understanding the calculation will help immunize your facility against F tags. - READER QUESTION:
To Code Or Not To Code … ADL Assistance In The Hospital
Question: Can nursing homes capture ADL care on the MDS if it was provided during [...] - CE OFFERING:
Ready To Earn 4.5 Nursing Continuing Education Contact Hours?
Read these objectives and take the online test. If you're interested in obtaining 4.5 continuing [...] - COMPLIANCE:
Random Audits Catch Not-So-Random MDS And Documentation Problems
Check out these facilities' simple strategies. To ensure your facility's documentation backs up the RUGs, [...] - PRACTICE TIP:
Ensure Your Nursing Facility Is Ready To Roll With Backup Documentation
An ounce of effort up front can prevent heavy-duty problems later. Implementing a consistent strategy to [...] - WHAT DO YOU THINK?--Can You Implement Strategies To Help Prevent Additional Development Requests?
The answer is no ... and yes. If you think of an additional development request [...] - MDS & Billing News
Get ready for updated code files for SNF consolidated billing. The annual updated list of [...] - CODING ACCURACY:
This Coding Combo For Influenza Vaccination Will Trigger A Fatal Record Error
The Centers for Medicare & Medicaid Services says the state database should give you a [...]